Female incontinence is the involuntary loss or leakage of urine. It is prompted by a physical activity like coughing, sneezing of heavy lifting which puts pressure on the bladder.
While urination the muscles of the urinary bladder contract and urine is pushed out of the bladder in the urethra. The muscles of the urethra relax to push the urine out of the body. If the muscles of the bladder contract all of a sudden or the muscles of the urethra are weak then it causes leakage of the urine.
The causes for urinary incontinence in women are childbirth, menopause, obesity, diabetes, urinary tract infections, imperfect nerve signals to the bladder, nerve signals at the incorrect time, chronic coughing or sneezing, excess consumption of caffeine, lack of ability to think, communicate and move (this is due to other medical conditions), weak bladder muscles, constipation, certain medicines, birth defects, stroke, paralysis and multiple sclerosis.
Urinary incontinence in general is more prevalent in women than in men. Further it is more often seen in aged women but it is not due to ageing.
Multiple pregnancy, child birth, menopause, obesity, ageing, inability to move, psychological problems and diabetes are the risk factors for female incontinence.
There are several types of incontinence and the symptoms depend upon the type of incontinence.
The types of incontinence are:
Stress incontinence
Urge incontinence
Overactive bladder
Functional incontinence
Overflow incontinence and
Transient incontinence.
In stres incontinence, the leakage is due to physical stress like pregnancy, child birth or menopause. Simple coughing, sneezing and laughing can also cause urinary incontinence. It is more severe in the previous week of the menstrual period because of the low estrogen level which reduces the pressure of urethra muscles.
In urge incontinence, there is an urge to urinate and meanwhile some urine is lost due to abnormal contraction of the bladder. This is due to lack of specific nerve signals.
In overactive bladder, there may be a leakage, urgent urge to urinate, leakage and urgent urge or need awakes in the night. This is due to signals of bladder nerves at wrong time.
The functional incontinence is due to lack of ability to think, communicate and move.
In overflow incontinence, there is an incomplete emptying of the bladder.
In transient incontinence the condition is temporary. It may be caused due to mental impairment, urinary tract infections, mobility restrictions, cold or constipation. In this once the trigger gets resolved the incontinence also ceases.
The condition can be diagnosed on the basis of medical history, physical examination and records of urination for several days or weeks called as voiding diary. It consists of information about amount of fluids taken, any drugs are being taken, urination time, stress, tension, amount of urine passed every time, diseases, surgery and incidents and approximate quantity of urine seepage.
Tests done are bladder stress test, ultrasound, urodynamics, cytoscopy, and urine analysis and urine culture.
Treatment for every type of incontinence is different. It can be regular bathroom visits (called as timed voiding), Kegel exercise, bladder relaxing drugs, biofeedback, neuromodulation technique, vaginal devices (insertion of pessary or a stiff ring into the vagina, use of urinary catheters, urethral plug), injecting bulking agents at the neck of the bladder, surgery or simply changing the current drug prescriptions (for example, drugs for high blood pressure).
After following timed voiding habits slowly there is a control over leakage. The type of surgery depends upon the cause of the urinary incontinence.
Treatment may include behavioral therapies to manage fluid intake and to strengthen pelvic floor.
Urinary incontinence may cause skin rashes, sores and infections due to persistently wet skin. It may cause urinary tract infections. It may limit the social and normal activities. It may disturb personal as well as professional life.
If urinary incontinence is restricting activities, limiting the social contacts or of there is blood in urine then it is important to call the health care provider.
Urinary incontinence can be prevented by maintaining healthy weight, quitting smoking, eating more fibers, being active, avoiding bladder irritants and doing Kegel exercise.
